Cardiac Cycle & Valvular Heart Disease Flashcards

1
Q

cardia cycle diagram

A
  • pressure and volume
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2
Q

pressure on the upper part

A
  • ventricular pressure
  • aortic pressure
  • left atrial pressure
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3
Q

volume on the lower part

A
  • end diastolic volume when the heart is filled
  • end systolic volume after the heart has ejected blood
  • stroke volume
  • difference bet EDV - ESV = SV
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4
Q

P wave

A
  • atrial depolarization
  • signal to the atrium to contract to push blood into the ventricles
  • during ventricular filling
  • during diastole
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5
Q

ventricular pressure

A
  • systole
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6
Q

contracting ATRIA

A
  • VENTRICLE is being filled
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7
Q

contacting VENTRICLE

A
  • ATRIA IS being filled
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8
Q

QRS

A
  • closure of the mitral valve (R wave) S1
  • depolarization of the ventricles
  • initiate systolic constriction ventricles
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9
Q

QRS valvular events

A
  • closure of the mitral valve
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10
Q

R wave

A
  • S1

- first heart sound

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11
Q

ventricular depolarization

A
  • pressure in the ventricle is increasing
  • isovolumetric contraction
  • ventricular pressure >80 mmHg
  • it pushes open the aortic valve, EDV
  • open of the aortic valve
  • blood is ejected to the aorta
  • aortic pressure is rising simultaneously with the ventricular pressure
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12
Q

ventricular pressure falls

A
  • causing fall in aortic pressure
  • beginning of T wave
  • ventricular repolarization to relax
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13
Q

T wave

A
  • ventricular repolarization (RELAX)
  • AORTIC PRESSURE >VENTRICULAR PRESSURE
  • S2 second heart sound
  • closure of the aortic valve
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14
Q

S2

A
  • second heart sound
  • closure of the aortic valve
  • closure of the pulmonary valve causing split weaker pressure
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15
Q

T wave valvular event

A
  • aortic closure

- S2

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16
Q

P wave in a EKG

A
  • atrial depolarization
  • mitral valve is opening
  • filling of the heart
  • no sound
  • S3, S4
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17
Q

atrial depolarization

A
  • S3, S4
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18
Q

QRS

A
  • ventricular depolarization
  • mitral close
  • S1
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19
Q

PR interval

A
  • AV node conduction
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20
Q

T wave

A
  • ventricular repolarization
  • closure of the aortic valve
  • S2
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21
Q

QT or ST interval

A
  • ejection phase

- aortic valve open

22
Q

S1

A
  • closure of the mitral valve and tricuspid valve
23
Q

S2

A
  • closure of aortic and pulmonary valve
24
Q

widening split of S2

A
  • pulmonary stenosis delay closure of the pulmonary valve

- right bundle branch block

25
Q

fixed splitting of S2

A
  • atrial septal defect (ASD)

- L=>R shunt

26
Q

paradoxical splitting

A
  • left bundle branch block

- advance aortic stenosis delay closure of aortic valve

27
Q

apical beat

A
  • 5th ICS MCL

- mitral valve

28
Q

aortic valve

A
  • second intercostal space R of the sternum
29
Q

pulmonary valve

A
  • second intercostal space L of the sternum
30
Q

tricuspid valve

A
  • 3rd, 4th , 5th intercostal space to the left of the sternum
31
Q

mitral area

A
  • 1st heart sound loudest

- due to closure of mitral valve

32
Q

aortic area

A
  • 2nd heart sound louder

-

33
Q

1st heart sound

A
  • finger rises in the carotid artery

- systolic interval

34
Q

2nd heart sound

A
  • finger falls in the carotid artery

- diastolic interval

35
Q

S3

A
  • heard early diastole
36
Q

S4

A
  • heard late diastole
37
Q

systolic murmur

A
  • heard in the S1

- rise of the finger

38
Q

diastolic murmur

A
  • heard S2

- fall of the finger

39
Q

murmur

A
  • systolic

- diastolic

40
Q

systolic murmur

A
  • aortic stenosis

- mitral insufficiency/regurgitation

41
Q

diastolic murmur

A
  • aortic insufficiency/regurgitation

- mitral stenosis

42
Q

S3

A
  • just after opening of the AV valves
  • during rapid filling, ventricle with a large chamber
  • normal finding in children and young adults
  • in older adults, occurs with volume overload, sign of cardiac disease
43
Q

S4

A
  • atrial contraction, during the last part of filling phase
  • stiff ventricle concentric hypertrophy
  • myocardial infarction
44
Q

venous pulse pressure tracing

A
  • jugular pulse which is generated by the right side of the heart
  • intrapleural pressure is closer point it zero
45
Q

venous pulse pressure tracing

A wave

A
  • coincides with the P wave in ECG
  • atrial contraction RA
  • correlates with the PR interval
  • stiff ventricle, pulmonic stenosis and insufficiency
  • absent in atrial fibrillation and other atrial arrhythmias
46
Q

venous pulse pressure tracing

V wave

A
  • biphasic decent and ascent
  • atrial filling during ventricular systole when the tricuspid valve is closed
  • peak corresponds to T wave opening of the tricuspid valve
  • occur in tricuspid insufficiency and right heart failure
47
Q

venous pulse pressure tracing

C wave

A
  • pressure in the veins due to bulging of the tricuspid valve
  • during ventricular contraction
  • coincides with the QRS in ECG
  • increase pressure of RV pushing blood to the RA, causing backing up pressure of the veins causing C wave
48
Q

venous pulse pressure tracing

X descent

A
  • decreasing atrial pressure during atrial relaxation
  • separated into two segments when the c wave is recorded
  • it occurs in atrial fibrillation and tricuspid insufficiency
49
Q

venous pulse pressure tracing

y descent

A
  • rapid filling of the right ventricle after opening of the tricuspid valve
  • tricuspid insufficiency
  • tricuspid stenosis
50
Q

atrial fibrillation

A
  • loosing the X descent
51
Q

tricuspid insufficiency

A
  • elevated V wave

- due to regurgitation of blood into the RA

52
Q

tricuspid stenosis

A
  • x descent will be less

- due to obstruction